Both describe colonoscopic ablation, but 44401 is for access through a stoma; 45388 is used for the standard route.
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CMS RVU26D · Effective 2026-10-01
44401 Colonoscopy ablation Medicare reimbursement rates in Texas
Reports endoscopic ablation of a colonic lesion during colonoscopy performed through a stoma, when tissue is treated rather than resected. Compare 44401 office and facility rates across CMS payment localities in Texas.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 44401 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$2361.93–$2720.32
8 of 8 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 44401 pays more and less in Texas
8 payment localities
$2361.93 to $2720.32
Gastroenterology
About 44401: Colonoscopy through stoma with ablation
Reports endoscopic ablation of a colonic lesion during colonoscopy performed through a stoma, when tissue is treated rather than resected.
A gastroenterologist or colorectal surgeon uses a colonoscope passed through a colostomy or other stoma to ablate a tumor, polyp, or other lesion in the colon. Ablation destroys the targeted tissue in place rather than removing it as a specimen; it may be selected when the lesion is not treated by a removal technique. The procedure is typically performed in a hospital outpatient or ambulatory endoscopy setting.
Report this code when the stoma is the route of access and ablation is the principal lesion treatment. The operative note should identify the stoma route, lesion location and treatment performed, and distinguish ablation from resection or injection. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed in the same session, endoscopy family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 44401
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.23 · 5%
- Practice expense (office) RVU72.58 · 94%
- Malpractice RVU0.47 · 1%
32
Medicare services in 2024 · #5623 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
44401 compared with similar codes
Office rates for Texas, from the same CMS release.
Both are stoma-route colonoscopy procedures. Choose 44401 for ablation and 44403 when the lesion is removed by endoscopic resection.
44404 describes injection during colonoscopy through a stoma. It is distinct from 44401, which reports ablation of a lesion.
Compare 44401 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $2720.32 | Facility $214.85 |
| Beaumont | Office $2361.93 | Facility $206.93 |
| Brazoria | Office $2557.08 | Facility $210.27 |
| Dallas | Office $2570.57 | Facility $211.92 |
| Fort Worth | Office $2546.53 | Facility $211.56 |
| Galveston | Office $2562.68 | Facility $211.14 |
| Houston | Office $2571.28 | Facility $219.74 |
| Rest Of Texas | Office $2456.06 | Facility $208.71 |
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44401 billing questions
How does this differ from 45388?
This code is for colonoscopy performed through a stoma. Code 45388 describes colonoscopic ablation through the standard route rather than through a stoma.
When should 44403 be selected instead?
Use 44403 when the lesion is treated by endoscopic resection through the stoma. Use 44401 when the documented treatment is ablation rather than removal.
Can ablation and another endoscopic service be reported together?
Related endoscopies performed in the same session are subject to CMS endoscopy family pricing. Document each service actually performed; the family-pricing rule affects payment.
Should modifier 50 be appended for multiple lesions?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor concerns colonoscopy through a stoma, not a bilateral procedure.
What documentation supports reporting 44401?
Document the stoma route, the lesion's location, and that the lesion was ablated. The note should make clear that treatment was ablation rather than resection or injection.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
